Depression and compliance with treatment in a sample of Northland diabetes patients.

AIM: The purposes of the study were to compare self-ratings and clinicians' ratings of compliance with treatment for diabetes among New Zealand European and Maori diabetes patients living in Northland Province, New Zealand; and to examine the unique relationships of demographic factors, diabetic history, and depression to the ratings. METHOD: A questionnaire containing demographic items, a depression inventory and a compliance rating scale devised in consultation with clinicians was completed by 99 diabetes patients attending the Northland Health retinopathic clinic. Clinicians independently rated the patients on a similar scale. RESULTS: Patients' ratings were unrelated to (but significantly higher than) clinicians' ratings. Patients were more depressed than a New Zealand normative sample; were more concerned than clinicians about treatment inconveniencing their lifestyle; and wanted more control over treatment options. Maori who strongly identified with Maori culture were as compliant as European patients, who in turn were more compliant than Maori whose identification was weak. Controlling for demographics and diabetic history, multiple regression analyses showed that depression uniquely accounted for variance in patients' ratings, but not in clinicians' ratings. CONCLUSION: Strategies to increase compliance include monitoring psychological wellbeing, establishing Maori case management clinics, negotiating individual treatment plans with patients and problem-solving training.